Jean Sterne (1919–1997)
One the world’s most widely used antidiabetic drugs has its roots in the Middle Ages, when Galega officinalis (French lilac or goat’s rue) was taken to treat this disease. The plant contains guanidine, found in 1918 to be responsible for the plant’s blood-sugar–lowering (hypoglycemic) effects, but it and several chemical derivatives were too toxic for use as medicines. In the 1920s, the derivative metformin produced hypoglycemic effects in rabbits, but the diabetes treatment world was focused on a far more dramatic drug: insulin.
In the 1940s and 1950s, several factors led to renewed interest in metformin. Orinase (tolbutamide), among the first oral hypoglycemic drugs effective in humans, generated considerable enthusiasm in medical and financial circles, and when used for the treatment of influenza, metformin was found to lower blood sugar with few toxic effects. Follow-up studies on these chance observations by the French diabetologist Jean Sterne—who named it Glucophage, or glucose eater—validated its potential usefulness as an antidiabetic drug. Glucophage was approved for use in Great Britain in 1958 and in Canada in 1972. Finally in 1995, it became available in the United States.
Type 2 diabetes is the most common and fastest growing form of diabetes, occurring increasingly in children and adolescents, with obesity and lack of exercise as major contributory factors leading to its development. With proper management, the progression of type 2 to type 1 diabetes (which requires insulin injections) and long-term complications can be delayed or even prevented.
FIRST CHOICE FOR TYPE 2 DIABETES. In a highly authoritative ten-year study in the United Kingdom reported in 1998, metformin (Glucophage) was the only oral drug shown to decrease the risk of diabetic complications and the death rate resulting from heart attack and stroke in type 2 patients. Use of this drug may also decrease the likelihood of developing type 2 diabetes in patients at risk, although vigorous exercise and diet are even more effective. Experts recommend that metformin—said to be the world’s most widely prescribed antidiabetic drug and one of only two oral antidiabetic drugs on the World Health Organization’s Model List of Essential Medicines—be included in the treatment of all type 2 diabetic patients.
SEE ALSO Insulin (1921), Orinase (1957), Human Insulin (1982), Avandia (2010).
During the late 1800s, goat’s rue (Galega officinalis, pictured) was thought to have potential as a fodder crop in Europe. It didn’t taste good, as perceived by cattle and horses, and it is now listed as a Federal noxious weed, but Glucophage—the medicine derived from it—is widely used for the treatment of diabetes.